Colorectal cancer is the third most common neoplasm worldwide. The mortality rate of newly diagnosed large bowel cancer approaches 50% and there has been little improvement over the past 40 years. Most of this mortality reflects local, regional and distant metastases.
Surgery is the mainstay of treatment for colorectal cancer but recurrence is frequent. Colorectal cancer has proven resistant to chemotherapy, although limited success has been achieved using a combination of 5-fluorouracil and levamisole. Surgery has had the largest impact on survival and, in some patients with limited disease, achieves a cure. However, surgery removes bulk tumor, leaving behind microscopic residual disease which ultimately results in recrudescence.
Early detection of primary, metastatic, and recurrent disease can significantly impact the prognosis of individuals suffering from colorectal cancer. Large bowel cancer diagnosed at an early stage has a significantly better outcome than that diagnosed at more advanced stages. Similarly, diagnosis of metastatic or recurrent disease earlier potentially carries with it a better prognosis.
Recent discoveries have shown that mutations of the human APC (Adenomatous Polyposis Coli) gene are responsible for both sporadic and familial colorectal cancers. Germ-line mutations of APC are found in inherited familial cancers such as Gardner's syndrome, attenuated adenomatous polyposis coli, heredity flat adenoma syndrome and familial adenomatous polyposis (FAP). FAP is an autosomal dominant inherited disease predisposing the patient to colon cancer. Patients inheriting a single mutant allele of APC develop hundreds to thousands of adenomatous polyps in the second to third decades of life, which if left untreated progress to malignant carcinomas. Genetic linkage analysis localized the APC gene to human chromosome 5q21-q22, a region frequently associated with allelic loss of the wildtype 5q allele. Mutations in APC are also implicated in sporadic colorectal cancers and in extracolonic tumors, such as gastric and small intestinal polyps, osteomas, sarcomas and desmoidal tumors.
There is a need for improved methods of treating individuals suffering from metastasized colon cancer. There is a need for compositions useful to treat individuals suffering from metastasized colon cancer. There is a need for improved methods of preventing a recurrence of metastasized colon cancer in individuals who have been treated for metastasized colon cancer. There is a need for compositions useful to prevent a recurrence of metastasized colon cancer in individuals who have been treated for metastasized colon cancer. There is a need for improved methods of preventing metastasized colon cancer in individuals, particularly those who have been identified as having a genetic predisposition for colon cancer. There is a need for compositions useful for preventing metastasized colon cancer in individuals.